This invention relates to a special replaceable accessory cord and handswitch set for use with an electrosurgical instrument having no handswitch. More particularly, a replaceable accessory cord and handswitch are supported on a terminal of the electrosurgical instrument so the handswitch is accessible to the surgeon controlling the electrosurgical energy delivery to a patient.
Any electrosurgical instrument, such as scissors, graspers, forceps and the like receive electrosurgical energy from an electrosurgical generator. A foot switch or hand switch controls the application of electrosurgical energy to the electrosurgical instrument. Surgeons frequently prefer the convenience of using a hand switch. Since one hand of the surgeon holds the electrosurgical instrument, the finger actuation of a switch on the electrosurgical instrument is convenient.
To minimize the cost of such electrosurgical instruments, suppliers frequently provide them without an integral handswitch for use by the surgeon. That omission benefits cleanability and sterilization after use, if it is a reusable electrosurgical instrument and minimizes replacement cost if it is disposable. Consideration of the addition of a convenient finger switch may not be worth added expense.
Control of high frequency electrosurgical energy at the electrosurgical instrument has long been a problem addressed in many ways. The use of fluidic control disclosed in U.S. Pat. No. 3,494,363 teaches squeezing a bulb or closing a vacuum port by the surgeon to control electrosurgical energy delivery to a forceps. U.S. Pat. No. 3,752,160 is a disposable electrode switch attached to a forceps and functional when the tines are squeezed together. In particular, the electrosurgical energy is transmitted in a monopolar application when a terminal on the cord contacts bare metal on the forceps. U.S. Pat. Nos. 4,370,980 and 4,552,143 have removable handswitches for electrocautery instruments. Conductive spring clips attach the handswitches to an electrosurgical instrument such as, scissors or a forceps. The electrically wired handswitch allows energy passage through electrically conductive clips for attachment to the electrosurgical instrument. Cutting or cauterizing electrosurgical energy passing through the handswitch depends on the operation of the button by the surgeon. Insulated handles of the electrosurgical instrument protect the surgeon from the electrosurgical energy but nothing protects the surgeon from the exposed conductive spring clips.
There has been a need to convert existing standard electrosurgical instruments such as, Endopath instruments by Johnson and Johnson or the Endo products of United States Surgical Corporation to hand switching with a simple and low cost replaceable accessory cord and handswitch set. No combination of a replaceable accessory cord and hand switch set attaches to where the regular cord set connects to afford finger switching. No combination replaceable accessory cord and handswitch set insulates the electrical connection of the connection. No replaceable cord and handswitch set provides a mechanical connection to support remotely disposed switch button. No replaceable cord and handswitch set provides secure attachment resistant to longitudinal movement and lateral movement relative to the electrosurgical instrument. No replaceable cord and handswitch set provides secure insulated electrical connection and an attachment for finger actuation of the switch button positioned to resist to longitudinal and lateral movement.
A replaceable accessory cord and handswitch set for use with an electrosurgical instrument by a surgeon on a patient in an electrosurgical circuit preferably connects between an electrosurgical generator, the electrosurgical instrument. The electrosurgical instrument for electrical connection to the electrosurgical generator in the circuit may have a proximal end for holding by the surgeon and a distal end for delivery therefrom of electrosurgery to the patient. A cord for electrically coupling to the electrosurgical generator most preferably supplies electrosurgery to the electrosurgical instrument with two or more conductors.
A handswitch electrically and removeably couples to one of the conductors and is preferably located on the replaceable accessory cord near the proximal end of the electrosurgical instrument for access by the surgeon. The handswitch is in the electrosurgical circuit. A pair of normally open contacts in the handswitch may preferably have one of the contacts attached to the active conductor and with either a cut waveform or a coagulation waveform conductor connected to the other contact. A receptacle on the handswitch can connect electrically to the active contact in the preferred embodiment. A terminal on the electrosurgical instrument may be configured to conjugate with the receptacle so the terminal would be in electrical contact with the active conductor.
A support on the handswitch for engagement with the electrosurgical instrument prevents movement relative therebetween. The support most preferably is electrically insulated from the pair of contacts, the receptacle, the terminal and the conductors. An operating button on the support may preferably be accessible to the surgeon. The operating button, positioned remotely from the receptacle and the terminal, is most preferrably electrically isolated from the pair of contacts, the receptacle, the terminal and the conductors. The operating button mounts for movement relative to the support and for closing the pair of contacts during use of the electrosurgical instrument when applying electrosurgical energy to the patient.
A handle is on the preferred embodiment of the electrosurgical instrument for use by the surgeon. One or more end effectors on the electrosurgical instrument preferably may apply electrosurgical energy. The support and operating button might be physically located on the handle so when the electrosurgical instrument is grasped by the handle the operating button is positioned for control by the surgeon""s finger of electrosurgical energy delivery. The handle is preferably insulated and at the proximal end of the electrosurgical instrument and the one or more electrosurgical effectors may be located opposite the handle at the distal end of the electrosurgical instrument. The one or more end effectors could include scissors, graspers. The one or more end effectors may alternately be a bipolar circuit with a return located on one of the end effectors. The return is connected to a return conductor for completing the electrosurgical circuit. The one or more end effectors when in a monopolar circuit can have a return pad on the patient as a part of the electrosurgical circuit.
The terminal most preferably is positioned near the proximal end of the electrosurgical instrument. The electrosurgical circuit for electrosurgical instrument for use by a surgeon on a patient may include one or more end effectors on the electrosurgical instrument for contact with the patient""s tissue during application of electrosurgical energy by the surgeon. The handle on the electrosurgical instrument could be at an end thereof opposite the one or more end effectors for positioning the one or more end effectors by the surgeon during the application of electrosurgical energy. The terminal on the electrosurgical instrument near the handle may receive electrosurgical energy for the one or more end effectors and may be electrically insulated from the handle. The handswitch removeably, electrically and mechanically can be connected and supported by the terminal. The handswitch is preferably electrically coupled to the terminal and the electrosurgical energy. The cord may detachably and electrically couple to the handswitch with one or more conductors therein for delivery of electrosurgical energy to the one or more end effectors. The electrosurgical generator can connect to the active conductor for supply of electrosurgical energy to the electrosurgical instrument handswitch. The electrosurgical generator connects to the return conductors coupled to one of the end effectors for return of the electrosurgical energy to the electrosurgical generator.
A button on the handswitch for closing the handswitch may apply electrosurgical energy to the one or more end effectors so as to be accessible to the handle so that electrosurgical energy can be selectively applied by the surgeon to the one or more end effectors. A support for the button may mount the button for finger actuation by the surgeon. The support can carry the button for movement relative thereto during actuation of the handswitch. The support for mechanically a connecting to the handle most preferably prevents relative movement therebetween.
The support electrically insulates from the button and the handswitch for preferably preventing leakage, stray currents or grounding to the surgeon. The support might include a pressure sensitive adhesive thereon to secure the button on the handle for access by a finger of the surgeon.
The electrosurgical generator and the cord electrically couple to the handswitch for allowing the selective electrically connection through conductors in the cord to effect the delivery of electrosurgical energy to the one or more end effectors. The cord can include a plug for removeably connecting the conductors to the electrosurgical generator. The handswitch may control the electrosurgical generator to cause delivery therefrom of electrosurgical energy with a coagulating wave form to the one or more end effectors. The electrosurgical instrument is preferably elongate between the handle and the one or more end effectors so that laparoscopic electrosurgery may be performed by the surgeon with control by the handswitch. A return may be connected to one of the end effectors for bipolar electrosurgery.